Information from 10 sentinel websites in Cambodia present a excessive prevalence of ceftriaxone-resistant and multidrug- and extensively drug-resistant (XDR) gonorrhea, researchers reported yesterday in JAC-Antimicrobial Resistance.
To analyze Neisseria gonorrhoeae ranges in Cambodia, which has been linked to instances of ceftriaxone-resistant gonorrhea in France and Australia, researchers with the World Well being Group (WHO) Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) analyzed urethral swabs of 437 male sufferers who offered on the 10 websites with urethral discharge from January 2022 to June 2023. Of these males, 306 had optimistic N gonorrhoeae cultures, antimicrobial resistance (AMR) check outcomes, and full epidemiologic information.
Findings of ‘grave concern’
Resistance ceftriaxone, cefixime, azithromycin, and ciprofloxacin was 15.4%, 43.1%, 14.4%, 97.1%, respectively. Nineteen (6.2%) of isolates collected from 7 of the ten sentinel websites have been proof against all 4 antibiotics and categorized as XDR. Moreover, 18 of the 19 XDR isolates displayed high-level resistance to azithromycin.
Essentially the most continuously reported remedy was the nationally advisable twin remedy of cefixime plus azithromycin, which was utilized in 65.4% of instances. The remainder have been handled with ceftriaxone plus azithromycin. Of the 30 sufferers who obtained a check of treatment, 11 (36.6%) have been nonetheless N gonorrhoeae–optimistic.
The authors of the research observe that the prevalence of resistance to ceftriaxone, cefixime, and azithromycin all exceeded the 5% AMR degree utilized by the WHO and different public well being businesses to point when the advisable first-line remedy ought to be modified. They are saying the findings are of “grave concern” each for Cambodia and from a world perspective.
“This necessitates expanded N. gonorrhoeae AMR surveillance, revision of the nationally advisable gonorrhoea remedy, necessary check of treatment, enhanced sexual contact notification, and finally novel antimicrobials for the remedy of gonorrhoea,” they wrote.
